Market Overview

Wisconsin DHS Deploys entellitrak to Support Medicaid Self-directed Benefits Program


Low-code COTS Solution Promotes Program Integrity and Data Sharing for
Innovative $500M Waiver Program

The Wisconsin Department of Health Services (WI DHS), Division of
Medicaid Services recently went live on entellitrak®,
MicroPact's low-code application development platform for case
management, to support its Medicaid Self-directed Long-Term Care (LTC)
Benefits Program, known as IRIS (Include, Respect, I
Self-Direct). The ~$500 million (annualized) Medicaid waiver
program enables approximately 17,000 eligible adults to choose the
long-term care services they receive in their homes and communities,
resulting in better outcomes for participants and annual savings for the
state of Wisconsin.

"Medicaid dollars consume a large share of state and federal budgets.
With future funding levels uncertain, self-directed program models
deserve consideration," said Chris Sell, Wisconsin Self Directed IT
System, System Administrator. "Not surprisingly, a common concern of
lawmakers is that self-directed programs may be vulnerable to the
perception of fraud and/or abuse. In Wisconsin, we have found the
majority of participants take pride in managing their LTC service budget
within the allocated amounts. With entellitrak, we have greater
transparency, access to real-time data, and tighter controls with
automated system validations that ensure program integrity."

IRIS is one of the largest Medicaid Home and Community-Based Services
1915(c) waiver programs in the country, yet WI DHS operates the program
with limited staff, reducing state administrative costs. More than 1,000
users from 14 different agencies access the web-based entellitrak
solution to coordinate services and support LTC outcomes for IRIS
participants, authorize and disburse payments to service providers, and
manage and report on the program. They include social workers, nurses,
and fiscal employer agents, as well as government analysts. Based on
their role and system permissions, authorized users can access, report
on, and share HIPAA-compliant information as needed.

"Just a few years ago, every contracted agency used its own siloed
system. Now we all leverage one centralized case management system:
entellitrak. DHS, DOJ, and OIG analysts all have direct access to
program data, further mitigating the perception of fraud, waste, and
abuse while providing evidence-based data to support decision makers,"
said Sell.

At a time when many states are looking for sustainable models for
delivering high-quality services to an aging population, they are also
under pressure to replace their monolithic Medicaid Enterprise Systems
with modular, interoperable solutions. The Centers for Medicare and
Medicaid Services continues to offer guidance, but it's up to each state
to define its own modules and deployment strategy.

"MES modernization is a huge undertaking, and states are turning to each
other to see what's working," said Kris Collo, CEO of MicroPact.
"Wisconsin's IRIS program stands out as the perfect microcosm — in terms
of the innovative services it provides, the tax dollars it saves, and
the COTS technology that can ensure solid program integrity with minimal
staff support."

entellitrak is used by benefits and entitlement programs throughout the
public sector to manage millions of cases annually, including
eligibility, care management, and claims processing.


entellitrak is a low-code application development platform for case
management and business process management. Whether based on-premises or
in the cloud, its Data-First™ approach allows it to be implemented
immediately and configured continuously, enabling customers to get to
work quickly while keeping costs low.


For nearly four decades, MicroPact has focused on engineering commercial
off the shelf (COTS) solutions for the public sector. Today MicroPact
solutions serve 98% of U.S. states, 97% of federal agencies with 500 or
more employees, and enjoy a 97% annual renewal rate. MicroPact, the
passion and technology that's transforming government.

About Wisconsin Department of Health Services

The Department of Health Services (DHS) is one of the largest and most
diverse state Departments in Wisconsin, with an annual budget of roughly
$11.5 billion and more than 6,100 employees. DHS is committed to
protecting and promoting the health and safety of the people of
Wisconsin, making sure everyone can live their best life.

DHS oversees Medicaid, the single largest program in the state budget,
and other health and social service programs. DHS ensures that the care
provided to Wisconsin residents is high-quality and provided in
accordance with state and federal law; ensures that Wisconsin taxpayer
dollars are being used effectively and efficiently by preventing and
detecting waste, fraud and abuse; and works to continue Wisconsin's long
tradition of strong health outcomes and innovation.

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